Ch. 20 Flashcards
(22 cards)
When is insulin production highest in the maternal body?
1st trimester
Elevated Estrogen and Progesterone levels in the 1st trimester will cause BG to do what?
BG will fall
What weeks will BG be the lowest?
13-20 weeks
What is a mother prone to with type 1 diabetes?
DKA diabetic ketoacidosis
Why is 13-20 weeks prone to hypoglycemia?
Placenta not developed, No glucogenesis yet, Insulinase develops with placenta
First trimester insulin needs
Lowered because of pancreas overproduction, and increased peripheral sensitivity
Second trimester insulin needs
increase because of hormones, cortisol and insulinase decreasing the effectiveness of insulin
Thrird Trimester insulin needs
Double or Quadruple, but level off at 36 weeks
Fetal side effects of type 2 diabetic mother
LGA, Poor lung maturity, Need teaching on diet and exercise
Best fetal outcome for a mother with diabetes
strict control on BG
How to diagnose a mother with GDM
At 28 weeks, 1 hr GTT with 50g, if BG is above 130 then 3 hr GTT with 100g. 2 positives = confirmation
Most common endocrine disorder
Diabetes
Three P’s of diabetes
Polydipsia, Polyphagia, Polyuria
Newborn is having BG problems after birth, why?
Pancreas is making much more insulin because of sugar from mom. Baby will become hypoglycemic
Complications with lupus during pregnancy
HTN, PTL, miscarriage. All relate to clotting
What medication would a pregnant woman with lupus receive
Lovenox (Low molecular weight heparin) - anticoagulant
Four P’s of drug abuse
Parents, Partner, Past, Pregnancy
Drug abuse - Parents
Parents of mother might have drug abuse problems
Drug abuse - Partner
Partner of mother might have drug and alcohol abuse problems
Drug abuse - Past
Has the mother had drug/alcohol problems in the past?
Drug abuse - Pregnancy
Was the mother an abuser before her pregnancy, and has she abused during the pregnancy
Sx of heroine withdrawal
SGA infant, decreased moro reflexes hypothermia or hyperthermia
